J Korean Soc Emerg Med.  2010 Feb;21(1):94-103.

Use of Sedative and Analgesics during Lumbar Puncture in Pediatric Patients: Pediatric and Emergency Medicine Residents'Experiences and Attitudes

• Park SY
• Seo JS
• Kim DK

Abstract

PURPOSE
The purpose of this study was to compare the patterns of clinical practice in procedural sedation and analgesia (PSA) during lumbar puncture (LP) between the emergency medicine residents (ER) and the pediatric residents (PR), and to evaluate factors that impeded decisions to use sedation and analgesia during LP.
METHODS
The survey was sent to ER and PR in a tertiary referral hospital. The survey inquired about clinical practice patterns, experience of PSA training, current administration of PSA during LP and factors that influence PSA use.
RESULTS
Sixteen ER and nineteen PR completed the survey. PR were more confident in LP skill than ER. ER used topical analgesic cream and injectable lidocaine more frequently than PR. The most influential factor in PR administering systemic sedative was the concern of respiratory compromise. PR reported less training opportunities during residency than ER.
CONCLUSION
Both ER and PR under-administered sedation and analgesia for LP in pediatric patients. ER were administering more injectable lidocaine and topical analgesic cream for LP in children compared to PR. In spite of the increased ER training opportunities, there are rooms for improvement in the practice of sedation and analgesia.

Keyword

Lumbar puncture; Children; Residents; Sedation; Analgesia

MeSH Terms

Analgesia
Analgesics
Child
Emergencies
Emergency Medicine
Humans
Internship and Residency
Lidocaine
Physician's Practice Patterns
Spinal Puncture
Tertiary Care Centers
Analgesics
Lidocaine